Provider Demographics
NPI:1548748353
Name:LEONE-ALDRICH, MICHAEL STEVENSON (LMFT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:STEVENSON
Last Name:LEONE-ALDRICH
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:STEVENSON
Other - Last Name:ALDRICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AMFT, APCC
Mailing Address - Street 1:1849 SAWTELLE BLVD STE 610
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-7013
Mailing Address - Country:US
Mailing Address - Phone:650-218-2160
Mailing Address - Fax:
Practice Address - Street 1:3701 LONG BEACH BLVD STE 3003
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3346
Practice Address - Country:US
Practice Address - Phone:909-859-0397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-02
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA128333106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist